Introducing the integrality concept

It’s clear from what we have discussed in Week 1 that we need to change the way we provide maternity care. The reasons are compelling:

Women are emerging from their birth experiences increasingly traumatised, with sky-high rates of birth-related post-traumatic stress symptoms, postnatal depression, and fear of childbirth.

Midwives - the main health care providers for pregnant and birthing women - are increasingly stressed, anxious and burning out, working in dysfunctional maternity care systems.

We know that where effective relationships are present in the maternity care system, a whole range of outcomes and experiences improve - yet at the moment, relationships and communication pathways between care providers are often less than optimal.

The key to making an effective change to the way we provide maternity care is finding a framework - a model - that enables us to build effective, sustainable relationships between care providers who share a common goal: to provide care that is wrapped around the woman and centred on her needs.

We already introduced you to the Lancet framework for optimal maternal and newborn care, which outlines key design features of a maternity care system. The Lancet framework gives us the big ideas, the overall picture. The key to making the framework work in practice is to promote and develop sustainable relationships between all care providers. To do that, we need a model to guide us through the practical steps of how to implement the framework.

This model needs to outline an integrated relationship-based maternity care system where the midwife works in partnership with the woman. Care needs to be seamlessly integrated across different departments and disciplines. This ideally happens through a midwife journeying with the woman and communicating effectively with the various caregivers that may contribute to her care: integrated care.

Next, we introduce the Integrality Framework, a simple yet powerful model that does just what we described - it enables the effective implementation of the Lancet framework for optimal maternal and newborn care.